In the interests of what journalists call balance (but might better be called equal time for the Flat Earth Society), an article appeared straight after mine, Integrating Homeopathy into Primary Care. It was by Rachel Roberts “Research consultant for the Society of Homeopaths”.

This defence was so appalling that I sent them a response (after first doing a bit of checking on its author). To my surprise, they published the response in full [download pdf of printed version]. Their title was

As always, the first step is to Google the author, to find out a bit more. It seems that Rachel Roberts runs a business Integrated Homeopathic Training. (a financial interest that was not mentioned in her article). She will sell you flash cards (‘Matmedcards’) for £70 (+£9 p&p) for 120 cards (yes, seriously). The card for Conium maculatum is remarkable. It says on the reverse side

Yes, it says (my emphasis)

“The poison used to execute Socrates. No 1 remedy for scirrhous breast cancer. Esp after blow to the breast”

No doubt she would claim that the word “remedy” was a special weasel word of homeopaths that did not imply any therapeutic efficacy. But its use in this context seems to me to be cruel deception, even murderous. It also appears to breach the Cancer Act 1939, as well as the Unfair Trading laws.

I asked the Bristol Trading Standards Office, and got a reply remarkably quickly. It ended thus.

“. . . . the use of the card for “hemlock” as an example amounts to advice in connection with the treatment (of cancer)”. I will initially write to IHT and require that they remove this, and any other, reference to cancer treatment from their website.

When I checked again a couple of weeks later, the hemlock sample card had been been replaced by one about chamomile (it is described as the opium of homeopathy. Luckily the pills contain no opium (and no chamomile either) or that would be breaking another law. Bafflingly, it is not (yet) against the law to sell pills that contain no trace of the ingredient on the label, if they are labelled ‘homeopathic’.

Presumably the packs still contain a claim to cure cancer. And what is said in the privacy of the consulting room will never be known.

Political correctness is a curious thing. I felt slightly guilty when I reported this breach of the Cancer Act. It felt almost sneaky. The feeling didn’t last long though. We are talking about sick people here.

It isn’t hard to imagine a desperate woman suffering from cancer reading that Ms Roberts knows the “No 1 remedy for scirrhous breast cancer”. She might actually believe it. She might buy some hemlock pills that contain no hemlock (or anything else). She might die as a result. It is not a joke. It is, literally, deadly serious.

It is also deadly serious that the Department of Health and some NHS managers are so stifled by political correctness that they refer to homeopaths as “professionals” and pay them money.

Ms Roberts, in her article, is at pains to point out that

“Registered members of the Society of Homeopaths (identified by the designation RSHom) have met required standards of education, are fully insured and have agreed to abide by a strict code of ethics and practice..”

No doubt they will say that the claim that asthma and migraine “responded well” to their sugar pills carries no suggestion that they can cure a named disease. And if you believe that, you’ll believe anything.

I have to say that I find Ms Robert’s article exceedingly puzzling. It comes with 29 references, so it looks, to use Goldacre’s word, ‘sciencey’. If you read the references, and more importantly, know about all the work that isn’t referred to, you see it is the very opposite of science. I see only two options.

Either it is deliberate deception designed to make money, or it shows, to a mind-boggling extent, an inability to understand what constitutes evidence.

The latter, more charitable, view is supported by the fact that Ms Roberts trots out, yet again, the infamous 2005 Spence paper, as though it constituted evidence for anything at all. In this paper 6544 patients at the Bristol Homeopathic Hospital were asked if the felt better after attending the out-patient department. Half of them reported that the felt ‘better’ or ‘much better’. Another 20% said they were ‘slightly better’ (but that is what you say to be nice to the doctor). The patients were not compared with any other group at all. What could be less surprising than that half of the relatively minor complaints that get referred for homeopathy get ‘better or much better’ on their own?

This sort of study can’t even tell you if homeopathic treatment has a placebo effect, never mind that it has a real effect of its own. It is a sign of the desperation of homeopaths that they keep citing this work.

Whatever the reason, the conclusion is clear. Never seek advice from someone who has a financial interest in the outcome. Ms Roberts makes her living from homeopathy. If she were to come to the same conclusion as the rest of the world, that it is a placebo and a fraud, her income would vanish. It is asking too much of anyone to do that.

This is the mistake made time and time again by the Department of Health and by the NHS. The Pittilo report does the same thing The execrably bad assessment of evidence in that report is, one suspects, not unrelated to the fact that it was done entirely by people who would lose their jobs if they were to come to any conclusion other than their treatments work.

At present , the regulation of alternative medicine is chaotic because the government and the dozen or so different quangos involved are trying to regulate while avoiding the single most important question – do the treatments work?

Yesterday in parliament, Lord Clement-Jones asked “whether patient choice and access to the Royal London Homeopathic Hospital is being restricted by some primary care trusts.”

Lord Darzi replied “The Government do not maintain a position on any complementary or alternative medicine treatments and it is the responsibility of the National Health Service to make decisions on what types of services or treatments they will commission and fund.”

I agree David. It is about time the Government did take a position and stop pretending that the question of effectiveness does not exist. We don’t need heavy handed regulation (like that required of banks after the government similarly ignored to take a position on them), but a straightforward assessment of the evidence and a mature discussion on that. Supporters of CAM appear unable to have that mature discussion. So, let NICE do its job.

Spot on DC – all alternative medicines ought to be submitted to rigorous tests of efficacy, and decisions as to whether or not to offer them via the NHS should rest solely on efficacy.

@ LCN: It so happens that yesterday I contacted a senior Westminster person (who for the sake of this discussion shall remain anonymous…) to discuss this very issue of a publicly-funded health service continuing to fudge the issue of efficacy WRT CAM – prateek dot buch at gmail dot com for more details…

@LCN – well, the answer to Lord Clement-Jones’s question is yes but no. But I think that the whole question of patient choice is a red herring. There is plenty of choice out there, it’s just not funded by the NHS. Not all of that choice necessarily falls into the private medicine category either – not-for-profit and charitable provision also exist.

Of course choice is a red herring. It is used as a an ‘unthink’ word by alt med advocates (like ‘freedom’, ‘pro-life’). Actually, what alt meds want is people to have the freedom to choose discredited and useless treatments so that the charlatans can profit from them.

the tactic of bringing in the word ‘choice’ is laughable. People don’t want choice as much as they want things that work – schools, hospitals (and by extension treatments), parks, trains, roads, just about everything. Choice is a by-word for deregulation in my book, deregulation and fragmentation of things that ought to be or still are in the public domain.

And of course if you really want choice, you can bugger off to the private or ‘third’ sectors, as warhelmet correctly points out

@LCD – no the CAM bunch seem to want public funding for what they do rather than the status quo, or a situation where PCTs are more and more reluctant to fund homeopathy et al. Well, in the context of the article that David slated.

And Darzi’s comments are correct in some ways, to the extent of trying to take the politics out of the equation. It might look like an abrogation of responsibility but political interference in public health has a bad track record.

Teek suggests that ‘if you want choice, you can bugger off to the private or ‘third’ sectors’. Is this what lecanardnoir meant by a mature discussion? Does that also mean that the tax and NI will be refunded to the patient being sold something he does not want?

It is unlikely that you have successfully treated yourself and family for hay-fever with homeopathic treatments. The homeopathic 30C treatments at http://www.truestarhealth.com/Notes/2228002.html appear to me to be pure water. The condition seems to vary with background pollen levels and the condition itself seems to come and go.

A better approach would be to establish four groups of patients. One control group would receive no treatment, the second would receive only sugar pills to examine placebo effect, the third would receive conventional medicine and the fourth homeopathic treatment. Provided honest, reliable and accurate measures of the severity and duration of symptoms could be established, you would predict that when you did your statistics and maths the fourth group would show the largest improvement. I believe the results would prove your hypothesis false and that the homeopathic treatment would be no better than placebo.

I can’t quote you a particular study on homeopathy/hay-fever, but in general many of the studies claiming that homeopathy works seems to suffer from poor design – no control group in the Spence study at the Bristol Homeopathic Hospital or poor mathematical analysis. When the studies are properly designed no real benefit to the patient is found.

The answer to your point “the question I now want to answer is how it works.” is that, as far as I can see, homeopathy does not work. The patients by definition are sick and suffering, part with lots of money for useless treatments out of desperation and gullibility. If they are led down the road of neglecting conventional medicine will probably suffer even more.

Alas, like those wonderful “treatments” being considered by the HPC, homeopathy is a solid part of the “woo economy”, and as such, suddenly closing it down would affect a great many people in terms of their income, and hence, the economy overall, and considering the parlous state the economy is in right now, well, I’ll leave it to you to conjecture.

Suffice it to say that those who derive their livelihoods from the woo economy hold profit and the exploitation of their fellows to be the highest good — even if it kills their fellows.

The `choice’ canard (!) is a political ploy to offload responsibility to patients. Yes, political interference in health care is not a good thing, which is exactly why the NHS is failing. Every pot of money dished out has a political agenda attached. It’s extremely convenient for the govnt to claim to work at arm’s length when it suits them, but in reality they are up to their elbows in it every day. They just avoid anything resembling a decision on CAM because they don’t want to upset the 70% of voters who are gullible enough to want it.

Andrew I’m glad you agree with me about the breast implants but how can you possibly say that you doubt I treated myself and my family successfully with homeopathy when you know nothing about our condition?
My hayfever was so bad before I started taking pollen that I could at times be practically unconscious. I could never go for a walk in the park without first being dosed up with massive amounts anti-histamine. When I first bought the homeopathic remedy I knew nothing about medicine; I simply bought it because I was having an attack and couldn’t get any anti-histamine. I remember wondering how something that made me ill would make me better, but as I had no alternative I bought it and it helped.
I didn’t immediately rush out and start buying only the homeopathic remedy. I just fell into buying it when I had no anti-histamine because it was cheap and easy to find. Later in a moment of boredom I did actually read the instructions and so began taking it at the beginning of the hayfever season to see if it would work. I can now go out walking in the park now without any anti-histamine. I would definitely say that was a cure.
I won’t bore you anymore with the details of the rest of my family, but would like to mention that I have just read about an injection out for this year which is said to be a long term cure when given over three of four years, about the same to as it takes to get a cure from homeopathy. It’s called Pollinex… and it contains pollen. I can’t help thinking why bother with all the trouble of going to the doctor to get an injection when it’s easier to just to buy the pollen pills.
And before you say they can’t possibly work because there is nothing in them, just wonder for a moment if we know how everything works, and question whether we should be so arrogant as to say something cannot work simply because we lack the understanding. Aren’t scientists supposed to question?

Sorry Andrew have just seen that I didn’t mention your comment that ‘When the studies are properly designed no real benefit to the patient is found.’

Can you tell me which studies these are? It’s not fair to just make a blanket statement like that! I would like to have a look and see what you consider a properly designed homeopathic study so I can judge for myself.

How do you know it was the sugar pill that ‘cured’ your hayfever? Here is another anecdote which does not prove anything, but which may be an example of what Andrew says above in that ‘the condition itself seems to come and go’.
My daughter used to have severe hayfever during her teens. She did not take homeopathic remedies – or anything else for that matter – but during her twenties she ceased to have any severe symptoms and no longer considers herself to be a hayfever sufferer. All this indicates is that there is one person whose hayfever was ‘cured’ without any intervention so it is possible for this to happen.

There is no need to sound so affronted that Andrew didn’t cite a specific reference. It is not a question of being unfair (an all-too-familiar cry from people who espouse CAM, often in relation to studies that show that treatments have similar effects to placebo): I am sure that, for the asking, Andrew or someone else will point you to specific studies and you could always do a search yourself if you feel so inclined.

Nobody claims that we know everything but HY violates much of the chemistry, physics and biology that we do know. If you want to get all metaphysical then suit yourself.

I don’t know how “life” works but I can demonstrate the evidence for it and the evidence for the absence of it.

The entire foundation of HY is built on sand. From meaningless, self-fulfilling and bizarre provings through to pills which contain more flyshit and glass molecules than active ingredients through to delivery of HY “cures” via email. Lunacy all of it.

If HY did what it’s practitioners say it does we would live in a disease free world in which all illness had been eradicated at almost zero cost. To date it has cured nothing, nor will it ever.

Like most quackery it was the invention of one person (although his motivation was probably more genuine than the charlatans who dreamed up chiro, osteo and the rest of the miserable portfolio of nonsense).

It violated medical knowledge 200 years ago and it currently violates both scientific knowledge and common sense.

You should have picked up the gauntlet rather than throwing it down. It is incumbent on quacks to provide demonstrable evidence that it works not on science to confirm that it is nonsense.

Try reading some books (many referenced here) which are written by people with a belief in and understanding of science who have no financial axe to grind with respect to propagating this mumbo-jumbo.

It almost died out until it was resurrected by age of Aquarius type hippy dippy chicks living in places like Putney.

Hi Linda
I did find that sometimes my hayfever ‘disappeared’ when I was a child but it was only ever when I went to the coast. It was also a lot less noticeable after I left school which was in the middle of a large park, but it soon returned when I started using the park again. So there can be a lot of reasons for its ‘disappearance’, but that is not a cure.
I wasn’t affronted by Andrew, merely teasing! I have found studies that indicate that homeopathy doesn’t work any better than a placebo but these are studies that only last for a few months. That’s a bit like expecting an aspirin to work in two minutes and then declaring that it doesn’t work at all because it didn’t work in two minutes and that the headache would have gone away anyway
Hi John
LOL! Thank you for making me laugh but please be serious!
Think I answered the point about studies in my reply to Linda and as far as the rest goes will just say, as I’m sure you really know, Hahnemann was against the quackery going on 200 years ago. His ideas about cleanliness were based on common sense.
Hi Claire
My point about Pollinex is that by treating like with like it is in line with Hahnemann’s early homeopathic principles and so it is not novel. It is following a principle that has been around many hundreds of years
Hi David
Yes, I will get around to reading the book; it is possible I will find things in the book that I already agree with. But would you just muse on this for a while (Please! Anything to just nudge you a fraction into seeing that somewhere out there are the answers to how homeopathy works if only there is someone with the time, intelligence and interest to find it); three thousand years ago the Chinese were wrapping themselves in red silk and lying in the sun to rid themselves of scars. Now we can use the same principles to get rid of wrinkles. Don’t you find it rather incredulous for that to work too?

Ok just read my sentence that says ‘somewhere out there’. Before you jump on it I will rephrase; ..anything to nudge you a fraction into seeing that the answers to how homeopathy works can be found if only there is someone with the time, intelligence and interest to research this area’!

Sorry, Lindy. Not quite sure who you were referring to when you stated ‘All this indicates is that there is one person whose hayfever was ‘cured’ without any intervention so it is possible for this to happen.’ I took the ‘one person’ as referring back to the last person you mentioned; your daughter. Did you actually mean me?

Perhaps you could point out which part of my post to you was not serious. I was utterly serious in the entire posting.

Which bit did you think was frivolous?

Was it the bit about the lunacy of provings?

Or was it the bit about how HY violates everything we know about chemistry, physics and medicine?

Was it the fact that HY has never eradicated any illness when it would be so cheap and simple to do so if it worked?

Was it about how no properly conducted research has ever vindicated HY?

Was it the bit about there having to be more contaminants in HY sugar pills than the alleged active ingredient? (Or do you know even more stuff which violates physics and chemistry)?

Let me know where exactly my frivolity ran away with me.

I even accepted that Hahnemann was probably sincere (which does not mean that he was correct) but what on earth do his views on cleanliness have to do with anything?

There is no relationship between HY and vaccination. This is a spurious connection which even HY quacks dropped a long time ago.

Far from being a watered down version of vaccination HY is based on the idea of “similars” and suggests that if something causes a set of effects it will cure an illness that manifests those symptoms. White pepper causes you to sneeze so it will cure colds. You will probably know more than me what dogs testicles, castles, shipwrecks and moonlight are meant to cure. Even more risible is the idea of signatures which suggests that like cures like if it looks like it – so sugar pills based on a trilobite fossil will cure flu because the fossils are the same shape as the flu virus. Feel free to tell me where the “medicine” is in this nonsense. It is all made up. Look at some of the other postings on Professor Colquhoun’s site for more information on how ludicrous this stuff is.

For most people hay fever tends to be self limiting. I note that your friendly sugar pill vendor had you on the pixy dust for a number of years. The phrase “he saw you coming, didn’t he” springs to mind. Or perhaps the line about there being one born every minute is more apposite (given that this is the corporate mission statement of quackery).

Trick or Treatment is good and objective as DC says but you could also try Ben Goldacre’s Book Bad Science. ttp://www.badscience.net/
Do let us know what you think if you read them.
I’m glad you were only teasing rather than being affronted! It is quite difficult to think clearly and logically about these different treatments, especially when feeling poorly. Also, we are all subject to such a lot of background influences-media coverage and the like which I think can be very poor. The Independent published an article a week or so ago which did little but quote acupuncturists saying acupuncture was worthwhile. There is plenty of evidence to indicate that it is not.

@ChristineSW15 – the ‘novelty’ I referred to is to do with the particular formulation of the new Pollinex Quattro vaccine, which promises a much shorter course of treatment for subcutaneous allergen immunotherapy than heretofore. I did not mean of the concept of desensitisation treatment for allergies.

As for desensitisation being line with Hahnemann’s early principles, I think that’s a bit of a loose interpretation. My understanding is that his Law of Similars proposes that a substance (n.b. not the exact substance but a “similar”) capable of producing symptoms in healthy individuals similar to those of the disease being treated will cure that disease in sufferers. Healthy people without hayfever do not suffer allergic symptoms from pollen, so the homeopathy-allergen immunotherapy analogy breaks down here. There is something called Isopathy, which is what you might be thinking of but my understanding is that Isopathy is a later invention and is disapproved of by “classical” homeopaths who follow Hahnemann.

Unfortunately, I think some supporters of homeopathy will continue to use scientific allergy research as a cover to promote their wares, despite the efforts of people like Dr Novella (article linked above). Here is a particularly irresponsible example of using recent, promising research in food allergy desensitisation to promote homeopathic products.

In fact this opens up an exciting opportunity for a new parlour game. “Guess That Quackery” is my patented new game for all the family.

All you have to do is think of something (anything at all) and see if there is a HY pill available from Ainsworths, Helios or Boiron.

Let your imagination run riot. Animal, vegetable or mineral – the wackier the better. Just think of something and look it up.

Don’t stop there though. You have the world of “imponderables” and “nosodes” to include in the game. Feel free to include intangible stuff like antimatter or yucky stuff like nasal mucus or cancer cells. The world is your oyster (and beyond – why not try sunlight).

Earn BONUS points for working out what the sugar pill is intended to cure. Remember kids, “like cures like” so let your imagination run away with you.

Your kids will love this game (ages 4-85) as they squirm at the thought of consuming leukaemia or leprosy (Don’t worry kids – there are no active molecules left). Or for that frisson of cannibalism why not have an Indian (Bangla Sahib: available in 12C, 15C, 30C).

Whilst I can’t find sunlight you can get air (atmospheric) and air (elemental) and summer solstice. Now there’s one for the guessing game. May be if you take it the days get shorter – or would it be longer, I can’t work it out?

You can get MMR, moonstone gem essence, ultrasound and X-ray. Also mobile phone (1800MHZ). My favourite though (this time) is
O.T.C. rubber, which presumably means diluted and vigourously shaken condoms which you can buy without a prescription.

In post 26 I invented a flu remedy based on fossil trilobites on the basis of “similars”.

Naughty but as meaningful/less as the rest of HY. I was merely trying to point out how stupid this stuff really is.

I simply looked at a picture of a flu virus and it reminded me of one of my many fossils. I have a fossil trilobite which is 250,000,034 years old (I can be accurate about that as it was 250M years old when I got it 34 years ago).

I should have realised that the quacks would be ahead of the game here. I was playing “Name That Quackery” (BUY NOW WHILE STOCKS LAST – FUN FOR ALL THE FAMILY) at lunchtime and lo and behold, what appears on Ainsworths list but:

As ever they are a bit cagey about telling you what it is supposed to cure but (a) I suppose it could be anything and (b) it doesn’t really matter anyway does it as it is complete nonsense. If I had to take a guess I would suggest probably lice.

Regarding the homeopathic treatment claiming to treat food allergies I linked to above (post 28), it seems the FDA is now investigating . Dr Nelson from the National Jewish Hospital (a leading centre for allergy & asthma treatment in USA) appears unimpressed by the protestations of homeopaths quoted.

[…] The House of Commons says that homeopathy is of no proven value, and yet the BBC gives a platform to this absurd woman, allowing her to tell the country that she believes that homeopathy cured her brain tumour. It gets worse. Gemma Hoefkens runs a homeopathy practice in Sutton Coldfield, near Birmingham. The website is here. This was not news. It was an advertorial. Does Gemma Hoefkens say she can cure cancer? Not in so many words, but she sails close to the wind by displaying her own tabloidesque life story. It’s a criminal offence under the Cancer Act to claim to be able to cure cancer as Rachel Roberts, another homeopath, knows only too well. (See “Rachel Roberts tries to defend homeopathy but breaches the Cancer Act” in DC’s Improbable Science) […]